Provider Demographics
NPI:1518423029
Name:BARRETT, MICHAEL RILEY (ATC)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:RILEY
Last Name:BARRETT
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1303 W 27TH ST APT 12
Mailing Address - Street 2:
Mailing Address - City:HAYS
Mailing Address - State:KS
Mailing Address - Zip Code:67601-1894
Mailing Address - Country:US
Mailing Address - Phone:712-592-0049
Mailing Address - Fax:
Practice Address - Street 1:1303 W 27TH ST APT 12
Practice Address - Street 2:
Practice Address - City:HAYS
Practice Address - State:KS
Practice Address - Zip Code:67601-1894
Practice Address - Country:US
Practice Address - Phone:712-592-0049
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-20
Last Update Date:2020-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic TrainerGroup - Multi-Specialty